What the panel ordered
Petition for Reconsideration denied by the Appeals Board on December 16, 2024.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The WCJ and Appeals Board found that applicant sustained heart trouble manifesting during employment, triggering the presumption of industrial causation under Labor Code sections 3212.2 and 3212.10, which defendant failed to rebut.
From the decision · page 2On September 25, 2024, the WCJ issued his decision, determining in relevant part that applicant sustained a cumulative injury in case no. ADJ16999983 from January 1, 2018 to August 18, 2022, but did not sustain a specific industrial injury in case no. ADJ17107739 on August 18, 2022. (Finding of Fact No. 2.) The WCJ determined that applicant sustained injury in the form of hypertension with heart problems, stroke, and damage to internal organs, resulting in permanent and total disability. The WCJ's Opinion on Decision explained that the medical reporting of QME Dr. Nacouzi supported the attachment of the presumptions of causation found in Labor Code1 sections 3212.2 and 3212.10, and that defendant had not overcome those presumptions.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant sustained heart trouble manifesting during employment as a correctional officer.
Favours Applicant prevailed
This fact triggered the presumption of industrial causation under Labor Code sections 3212.2 and 3212.10, which defendant failed to rebut.
From the decision · page 2On September 25, 2024, the WCJ issued his decision, determining in relevant part that applicant sustained a cumulative injury in case no. ADJ16999983 from January 1, 2018 to August 18, 2022, but did not sustain a specific industrial injury in case no. ADJ17107739 on August 18, 2022. (Finding of Fact No. 2.) The WCJ determined that applicant sustained injury in the form of hypertension with heart problems, stroke, and damage to internal organs, resulting in permanent and total disability. The WCJ's Opinion on Decision explained that the medical reporting of QME Dr. Nacouzi supported the attachment of the presumptions of causation found in Labor Code1 sections 3212.2 and 3212.10, and that defendant had not overcome those presumptions.
Echocardiogram findings showed mild left ventricular hypertrophy, supporting the diagnosis of heart trouble.
Favours Applicant prevailed
These objective test results formed the basis of the QME's medical opinion and supported the presumption of industrial causation.
From the decision · page 5We agree. The reporting and deposition testimony of Dr. Nacouzi establishes that applicant's echocardiogram study results were a reasonable basis upon which the QME could reach the reasoned and carefully explicated opinion that applicant had suffered "heart trouble" within the meaning of sections 3212.2 and 3212.10. The QME has offered extensive testimony regarding his analysis of the echocardiogram testing, as summarized in the following deposition excerpt:
Defendant did not provide evidence to rebut the presumption of compensability.
Favours Applicant prevailed
Without rebuttal, the presumption of industrial causation stood, entitling applicant to permanent and total disability benefits.
From the decision · page 7We therefore conclude that because applicant sustained "heart trouble" developing or manifesting during applicant's service as a corrections officer, his injury is presumed to have arisen out of and in the course of employment. (Lab. Code, § 3202.2; 3202.10.) Following our independent review of the record occasioned by defendant's Petition, we agree with the WCJ that the defendant has not rebutted the presumption of compensability, and that applicant is therefore entitled to an unapportioned award of permanent and total disability. (Lab. Code, § 4663(e).) We will deny reconsideration, accordingly.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Dr. Nacouzi opined that applicant sustained heart trouble including mild left ventricular hypertrophy based on echocardiogram findings, contributing to cerebrovascular injury and stroke, supporting the presumption of industrial causation under Labor Code sections 3212.2 and 3212.10.
The WCJ and Appeals Board relied on Dr. Nacouzi's detailed analysis of echocardiogram results and deposition testimony to find his opinion substantial medical evidence despite defendant's contention that a cardiac MRI was needed.
From the decision · page 2On September 25, 2024, the WCJ issued his decision, determining in relevant part that applicant sustained a cumulative injury in case no. ADJ16999983 from January 1, 2018 to August 18, 2022, but did not sustain a specific industrial injury in case no. ADJ17107739 on August 18, 2022. (Finding of Fact No. 2.) The WCJ determined that applicant sustained injury in the form of hypertension with heart problems, stroke, and damage to internal organs, resulting in permanent and total disability. The WCJ's Opinion on Decision explained that the medical reporting of QME Dr. Nacouzi supported the attachment of the presumptions of causation found in Labor Code1 sections 3212.2 and 3212.10, and that defendant had not overcome those presumptions.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code sections 3212.2 and 3212.10
Presumption of industrial causation under Labor Code sections 3212.2 and 3212.10
Applicant's heart trouble manifested during employment, triggering the presumption which defendant failed to rebut.
From the decision · page 2On September 25, 2024, the WCJ issued his decision, determining in relevant part that applicant sustained a cumulative injury in case no. ADJ16999983 from January 1, 2018 to August 18, 2022, but did not sustain a specific industrial injury in case no. ADJ17107739 on August 18, 2022. (Finding of Fact No. 2.) The WCJ determined that applicant sustained injury in the form of hypertension with heart problems, stroke, and damage to internal organs, resulting in permanent and total disability. The WCJ's Opinion on Decision explained that the medical reporting of QME Dr. Nacouzi supported the attachment of the presumptions of causation found in Labor Code1 sections 3212.2 and 3212.10, and that defendant had not overcome those presumptions.
What proof carried it
The evidence the panel weighed, by kind.
Echocardiogram findings of mild left ventricular hypertrophy
From the decision · page 5We agree. The reporting and deposition testimony of Dr. Nacouzi establishes that applicant's echocardiogram study results were a reasonable basis upon which the QME could reach the reasoned and carefully explicated opinion that applicant had suffered "heart trouble" within the meaning of sections 3212.2 and 3212.10. The QME has offered extensive testimony regarding his analysis of the echocardiogram testing, as summarized in the following deposition excerpt:
Defendant did not rebut presumption of industrial causation
From the decision · page 7We therefore conclude that because applicant sustained "heart trouble" developing or manifesting during applicant's service as a corrections officer, his injury is presumed to have arisen out of and in the course of employment. (Lab. Code, § 3202.2; 3202.10.) Following our independent review of the record occasioned by defendant's Petition, we agree with the WCJ that the defendant has not rebutted the presumption of compensability, and that applicant is therefore entitled to an unapportioned award of permanent and total disability. (Lab. Code, § 4663(e).) We will deny reconsideration, accordingly.
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About this page
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